It's Monday. Some Improvement!

It's Monday. June 11, 2012.  Max had a weekend full of ups and downs. Fri he showed some improvement with his reflexes and was able to swallow for the first time since his big seizure and going into a coma (induced to stop the seizure).  Saturday was not such a good day.  Max was flat and dull, and didn't reflex respond to much at all. He wasn't swallowing either.  When we went back to visit at night I noticed he had a blood shot eye.

Sunday though was a good day! I spent about 5 hours with him massaging his ears just like a few people had told me to do, from the base of the ear to the tip. Apparently this is like reflexology or similar to hitting all the important points in acupuncture / acupressure to help stimulate the body.  I don't know, but by the time I left last night, his pupil (we could only see one because of the scarring on Max's other eye from when I accidentally dropped him the night before his cyber knife) had gone back to normal size and was responsive to light.  I thought I could see him following people in the Emergency Room but wasn't sure.  He kicked the tech before the tech touched him, he bit me and the tech when we were messing with his mouth. He yawned a few times and pulled his tongue back in and repositioned it where it was supposed to be. He sneezed, he coughed. He looked like he might be able to hold his head up a little when they were coupaging him but it did fall down.  His muscles can shake him head as a reflex but he doesn't quite have the control to hold it up on command like he used to.  He also was swallowing quite a bit.  While I was massaging his ears he also started to pant and opened his mouth and panted that way. When I stopped rubbing he closed his mouth and stopped panting. Still a reflex to regulate his body temp, but something new.   Maybe there is something to that ear rubbing???

They also had reduced his keppra to 100mg 1x day, and reduced a number of his other drugs on Saturday so maybe his body was just adjusting.

This morning's call with his neurologist was encouraging and he said his reflexes were crisp and more consistent. Mentioned his eyes and that when he touched Max he seemed to respond appropriately. He said he thought we had a little improvement! Improvement is good! Of course we still don't know where we will be with regards to brain function until he totally recovers..  He also mentioned we're going to have up and down days, recovery ebbs and flows, so we have to look at it as a big picture vs day by day.  He also mentioned that there isn't a lot of information out there about how dogs recover from coma's, so hopefully what we're doing will help others in similar situations, just like all of my blogging about what Max went through with the brain tumors and the cyber knife.

Today Max is getting a feeding tube put in.  The goal behind doing this is two fold. 1) To give Max more time to recover and 2) Let Max go home to recover at home.  They should be putting it in early afternoon. Then they're not going to use it for 24 hours and then tomorrow they will start with water and see how he absorbs that, and then start on some gruel and see how that goes.

The positive:  He will no longer need his urine bag (which could be a negative from a clean up perspective!) His tummy will hopefully start working, he'll get more nutrients and hopefully be able to get stronger

The negative:  He's going to be pooping now and he can't get up to go out yet!  Good thing we have a big box of pee pee pads from Daisy still!

I was told that I'm going to need to build Max a ramp to sleep on about 6 inches high on one end. Put a yoga mat over it for traction and then his bedding... However, while walking the dogs this morning we saw a bean bag toss toy out in someone's front yard that looks exactly like what we need to build.  Luckly the Local ACE hardware store carries them... might be a very easy solution!  Max also will need small t-shirts to cover his feeding tube and keep it clean, so I've got to go get him a little wardrobe!  (100% cotton - he broke out when he was modeling for Christian Dior at Sax 5th avenue that one time!  Yes Max has been a runway model in his earlier years.. not much he hasn't done!)

Please keep those good positive thoughts coming Max's way for a good strong recovery!  He's making baby steps but he's definitely improving!  I'd love to see him running again!  I keep remembers that he was in a similar position last Sept and he came out of it running and jumping and chasing puppies!  He is a super dog!!!  He deserves a shot at showing the world what he can do!

Max Update - BIG Seizure..

Max had a massive seizure yesterday... it wouldn't stop. I managed to get him to the local vet to get some injectible vallium and then got him up to the hospital an hour away to his neurologist.

They got him stabilized, and did an MRI and blood work..

Good news... is that the Cyber knife completely - I MEAN COMPLETELY!!!!!  got rid of the tumor on his brain stem!  How amazing is this!!!!!!!  His blood work was relatively good too.

The tumor on the left side of his brain was still there and may not be a meningioma since it didn't respond.  But it could be b/c it didn't increase in size... and may have just gone dormant... so from all of that.. all - things considered, he's doing great..

BUT then there's the long cluster seizure... The MRI also showed blood in Max's brain... He had a bleed- it's contained (vs all over his brain - which is a positive)... so we're trying to stop the bleed and then flush out the edema and the blood... They put him in a drug induced comma to stop the seizing.. and we started him on emergency yunnnan baiyao last night.. today they are going to work on slowly trying to wean him down from the drugs and bring him back to awareness if we can keep him from seizing...


The bleeding is what's causing the seizures.. Dr. Joseph mentioned he'd seen latent damage to blood vessels in some CK patients and that's what it looks like has happened with Max. We have him on Yunnan baiyao to try to stop bleeding, then try and figure out how to flush the swelling and blood out of the brain.. We also want to see if we can reduce the drugs he's on and make him more aware and if we can get him to come out of the comma and give him time to get back to normal... gonna be a slow process.. Going back up to the Hospital in a few with more emergency yunnan Baiyao...

One other good thing... during his seizures his color stayed pink so he was still getting oxygen to his brain which hopefully means no brain damage... time will tell but we definitely have some good things going on here... Just need to get rid of the edema and the blood.    Last I heard his last seizure was around 2AM.. it's just about 2pm...   so hopefully that's a good sign ... I'll find out more when I get up to the hospital

One other thing to note -  Max did not get his anti-seizure meds when both of his last seizures took place. 

Keep those prayers, white light, good energy, good vibes, and good thoughts, etc coming!!! .. He's a fighter!!!

Max's Neuro Check up and anti-Seizure meds

Last week Max went in for his neurology check up, the first since his Cyber Knife.  He's been doing well.  We talked about how his hearing seemed to disappear when we lowered his prednisone dose to 10mg every other day so we decided to keep him on 10mg every day for now.  We're also working on weaning him over to the natural hydrocortisone. We did another full week of 10mg of prednisone every day, then the following week 10mg or prednisone every other day and on the other days we did 20-30 mg of natural hydrocortisone (soy-based and less effects on the liver/kidneys).  Now we're up to 10mg of prednisone and 2 days of natural hydrocortisone, then 1 day of prednisone and 2 days of natural hydrocortisone.  I'm happy to say Max's hearing and vision are great and I don't see any issues this time!

Dr. Young checked Max's eye as well and said it looked like it was healing well.  He could see through the cloudy scar tissue in his eye. He's doing well with his eye drops and anti-biotic ointment. He goes back to the eye doctor for a re-check next week,

The other issue we talked about were Max's anti-seizure medications.  All of the neurologists who have taken care of Max have suggested he be on anti-seizure medication .. just in case.  Dr. Joseph said he has seen dogs who have never had seizures have really bad ones that seem to come out of nowhere, and it's better to be on a preventative.  My one concern is, Max is not doing very well with these anti-seizure meds. He's not himself, and they make him very drunk.  He was first prescribed zonisamide. Max weighs 48 lbs. He was prescribed 200mg 2x/day.  He was pretty much a mess on this. It does take a while for them to build up a tolerance to the medication, much like you build up a tolerance to drinking or any other drug. Max had a really rough time and didn't seem to be building up any tolerance.  He lost his appetite all together, would vomit and had really bad diarrhea, and was extremely wobbly, anxious and walked around like a drunk guy.  I seemed to be able to get him to be ok on 100mg 1 time a day - given at night.  Dr. Young wanted to try at least 100mg 2x/day, but it's hard for Max to function during the day and we felt like his quality of life just wasn't there. The hard part is- you want them to have a good quality of life.. We went through this to save him, not to have him live the rest of his life in a fog.  Max is the Alex P. Keaton of Dogs!  He's always had serious OCD... He likes everything in it's particular spot, can't stand it when a dog can't walk in a straight line and needs to go run over and smell something..

Dr. Young suggested switching Max over to Keppra. He was prescribed 500mg 3x day.  The problem with this dose was that we gave Max his dose at 6pm and he did not wake up until 3AM the next day. Not even for dinner, or breakfast or to go out!  I couldn't even get his 2nd and 3rd doses in.  The next day I tried 250mg at night and he went out again and woke up to eat breakfast and then went back to sleep and around 1pm got up - very groggy, went potty, ate something, took a short walk, then another 250mg and he was out again until the next morning..   At this time, I'm hoping that he builds up some sort of tolerance to Keppra.   The positives of the Keppra are that he is not nauseous, his poops are solid, he doesn't seem very agitated, especially if I can get him out for a good walk in the afternoon.  He will sleep through the night.

I don't like to be woken up by drunk dogs in the middle of the night!!!

We had one little instance last night though, he didn't get his walk and was getting his exercise by walking all around the house (which he's always done if he doesn't get to go for a walk - think of a dog who needs to go to the gym religiously every day.. that's always been Max - so this isn't too abnormal for him) Anyway - at midnight he was doing his laps, and was drunk from his medication and I suppose stumbled over the dog bed where our rottie mix was sleeping, and she's apparently had it with Drunk Max. She jumped up out of bed with her horrible growley voice and decided Max needed his nose pierced.. you know.. just in case he decided he needed to get a nose ring with all the drugs he's been taking.. then she figured she should also pierce his tongue while she was at it... just in case Max REALLY wanted to be a rebel.. (Again - this is the equivalent to Alex P. Keaton getting a tongue and nose ring..... Sober Max has severe OCD... Drunk Max.. not so much.)

So Ms. Buttercup spent the rest of the night locked in Tom's office. She has yet to apologize to Max.  Max seems to be fine today.  Normally Buttercup is a lovely girl... like the rest of us though, she doesn't like to be stepped on or have someone fall on her in the middle of the night while she's sleeping, regardless of whether they can see or hear and especially not if they are drunk!